Risk factors of neonatal hypoglycemia

  • Yuliana Yunarto Department of Pediatrics, Faculty of Medicine, Diponegoro University-Dr. Kariadi Hospital
  • Gatot Irawan Sarosa Department of Pediatrics, Faculty of Medicine, Diponegoro University/ Dr. Kariadi Hospital, Semarang
Keywords: neonatal hypoglicemia; birth asphyxia; low birth weight; small for gestational age; prematurity


Background Hypoglycemia is the most common metabolic issue in newborns and should be treated as soon as possible to prevent complications of neurologic impairment, mental retardation, developmental delay, and cardiovascular disorders.

Objective To assess maternal, fetal, and neonatal factors for identifying infants at risk of developing neonatal hypoglycemia.

Methods This  case-control study was conducted in the Perinatal Unit of Dr. Kariadi Hospital, Semarang, Central Java. A total of 123 newborns with blood glucose <47 mg/dL comprised the case group and 123 newborns without hypoglycemia comprised the control group. Characteristics of infants, maternal age, maternal pregnancy-related conditions, as well as fetal and neonatal factors were recorded and analyzed for possible relationships with hypoglycemia.

Results Out of 677 newborns, hypoglycemia was found in 123 (18.2%) infants (59 male, 64 female). In the case group, 58 (47.1%) were preterm, 38 (30.9%) very preterm, and 8 (6.5%) extremely preterm infants. Factors associated with neonatal hypoglycemia were prematurity (OR 6.537; 95%CI 3.543 to 12.063; P <0.001), low birth weight (OR 2.979; 95% CI 1.532 to 5.795; P<0.001), small for gestational age (OR 1.805; 95% CI 1.054 to 3.095; P=0.031), and birth asphyxia(OR 3.386; 95% CI 1.945 to 5.895; P<0.001). In multivariate regression analysis, prematurity and low birth weight remained the significant factors associated with neonatal hypoglycemia.

Conclusion  Prematurity and low birth weight are significant risk factors associated with neonatal hypoglycemia. Routine screening and monitoring of blood glucose is recommended for preterm newborns and infants with low birth weight


1. McGowan JE. Neonatal hypoglycemia. NeoReviews. 1999;20:6-15.
2. Bromiker R, Perry A, Kasirer Y, Einav S, Klinger G, Levy-Khademi F. Early neonatal hypoglycemia: incidence of and risk factors. A cohort study using universal point of care screening. J Matern Fetal Neonatal Med. 2017;26:1-7.
3. Sharma A, Davis A, Shekhawat PS. Hypoglycemia in the preterm neonate: etiopathogenesis, diagnosis, management and long-term outcomes. Transl Pediatr. 2017;6:335-48.
4. De AK, Biswas R, Samanta M, Kundu CK. Study of blood glucose level in normal and low birth weight newborns and impact of early breast feeding in a tertiary care centre. Ann Nigerian Med. 2011;5:53-8.
5. Ho J; Malaysian Very Low Birth Weight Study Group. Mortality and morbidity of the small for gestational age (SGA) very low birth weight (VLBW) Malaysian Infant. Singapore Med J. 2001;42:355-9.
6. Ramzan M, Razzaq A, Kiyani AN. Hypoglycemia in small for gestational age neonates based on gestational age, gender, birth weight and mode of delivery. Pak Armed Forces Med J. 2017;67:397-400.
7. Hussein SM, Salih Y, Rayis DA, Bilal JA, Adam I. Low neonatal blood glucose levels in cesarean-delivered term newborns at Khartoum Hospital, Sudan. Diagn Pathol. 2014;9:112.
8. Kiran B, Dhananjaya CD. Clinical profile of hypoglycemia in newborn babies in a rural hospital setting. Int J Biol Med Res. 2011;2:1110-4.
9. Kallem VR, Pandita A, Gupta G. Hypoglycemia : when to treat ? Clin Med Insights Pediatr. 2017; 11:1-9.
How to Cite
Yunarto Y, Sarosa G. Risk factors of neonatal hypoglycemia. PI [Internet]. 11Oct.2019 [cited 8Jun.2023];59(5):252-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2156
Received 2019-03-02
Accepted 2019-10-11
Published 2019-10-11